Ava Grace: 1 pound, 3 ounces of pluck

Ava Grace: 1 pound, 3 ounces of pluck

GROWING — Ava weighs 15 pounds now and the medical folks say if everything goes according to plan she will catch up with her peers by the age of 5. (Paul Church/The Courier-Tribune)

By Faith KiddSpecial to The Courier-Tribune

ASHEBORO — Ava Fogleman was finally able to go out in public on Christmas Eve, more than a year after she was born.

She does not leave home much unless she is on her way to one of the many doctors she still goes to. Her first non-medical outing was a fitting one: Her parents, Al and Amy, bundled her up and took her to church for communion.

Ava’s middle name is Grace.

Her parents chose the name because Ava is here by the grace of God.

On a mid-December Sunday in 2012, Amy walked into Women’s Hospital in Greensboro. She was 23 weeks pregnant. Her baby was not due for four months, but she was feeling uncomfortable.

Little Ava Grace came into the world five days later, on Dec. 21, weighing just 1 pound, 3 ounces.

Ava weighs 15 pounds now and still makes weekly doctor visits, but the medical folks say if everything goes according to plan, she will catch up with her peers by the age of 5.

“We were so blessed that whatever has happened to Ava is stuff that they can work with,” Amy said. “According to all the things medically wrong with her, she shouldn’t be here.”

The roller-coaster ride began as soon as Amy showed up at the hospital complaining of discomfort back on that December day. The nurse who checked her out could not believe Amy had walked in without any pain: Her amniotic sac was hanging through her cervix. She was placed in the Trendelenburg position, her feet positioned above her head.

“How long must I stay like this?” Amy asked.

“Until your water bag goes back to where it should be, or until you have your baby,” the nurse replied.

On Monday, her water broke. Amy thought the game was over. Little did she know that did not mean the baby was on its way immediately. She could not even sit up to eat. Her husband had to feed her because every time she would sit up amniotic fluids would exit the body. Her baby could not survive without those fluids.

On Friday, she began to feel pain. She had been on medications throughout the week trying to stop the labor. But now, nothing was working. The doctor informed Al and Amy that 24 weeks is considered viable. They were of one mind: “Whatever it takes to save her, do it.”

The next thing they knew, they were in the delivery room, Al by Amy’s side, and doctors were getting ready to perform a C-section. It was too late for any pain medication. Amy began to pray, asking for strength.

The doctor was putting on gloves when suddenly, without even a push, the baby was born. The new parents had been warned that they would not hear her cry because her lungs had not developed yet. But cry she did, three times, before she was placed into an incubator and whisked off to the neonatal intensive care unit.

At 7 o’clock that night, Al and Amy were able to see their miracle. “It was like looking at ‘Baby in a Box,’ ” Amy said.

Her parents were not allowed to touch Ava until she was 6 weeks old. Even then they could not rub her skin because it was so fragile. Her grandparents were not able to hold her for three months.

But Al and Amy got to do something most other parents do not get to do: They watched their child develop: “When she opened her eyes,” Amy said, “it was so strange, because we were used to looking at her as always asleep.”

Everything seemed fine at first. Mommy and baby were both doing well. But on the day after Christmas, Ava was transferred to Brenner Children’s Hospital by ambulance due to a spontaneous intestinal perforation. She went into emergency surgery around 5 or 6 in the morning. Around 8 o’clock, the surgeon delivered good news. He had made her an ostomy bag which would remain until she left the hospital, but Ava had made it through.

A few days later, another intestinal perforation required another medical procedure. A month passed before Ava developed necrotizing enterocolitis (NEC), a gastrointestinal disease with a high mortality rate.

Ava survived it all. On April 1, the doctors reversed her ostomy bag and removed the dead tissue in her intestines due to the NEC. It actually took three surgeries to complete the job. After the first surgery, a waiting game began for the baby to “make poo.”

“I’ve never been so excited about poo in all my life,” Amy said.

But the challenges were not over. Ava contracted a rhinovirus infection, then needed more surgery to treat reflux and pulmonary hypertension, conditions connected to lung and kidney function. Doctors said they needed to bring the stomach up and wrap it around the esophagus so nothing would be able to come back up through the esophagus. So, in June, Ava underwent her third big belly surgery.

Ava finally arrived home in August. She was on oxygen, had an apnea monitor and a pulse oximeter. She is still connected to a feeding tube, which she will probably have until she is 2 or 3. Ava cannot consume food the same way a normal baby does, nor can she eat “big” meals. Through the feeding tube she is fed constantly, 27 milliliters (5.5 teaspoons) an hour.

Ava has had people all over the world — from Belgium to Afghanistan, Florida to Utah — praying for her.

My faith is stronger now,” said Amy.

Her story influences the life of every person who hears it. Even though she is only a year old, her journey has brought hope to many who are struggling.

A sign in Ava’s room tells the story: “Such a big miracle in such a little girl.”